Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study

Background: Postdural puncture headache (PDPH) is a common complication after lumbar puncture. Anesthesiologists are the most likely to be consulted for the treatment. PDPH may be debilitating for a patient and can interfere with daily activities and quality of life. Methods: Fifty patients of both...

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Main Authors: Dina Y. Kassim, Ibrahim M. Esmat
Format: Article
Language:English
Published: Taylor & Francis Group 2016-07-01
Series:Egyptian Journal of Anaesthesia
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110184916300332
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author Dina Y. Kassim
Ibrahim M. Esmat
author_facet Dina Y. Kassim
Ibrahim M. Esmat
author_sort Dina Y. Kassim
collection DOAJ
description Background: Postdural puncture headache (PDPH) is a common complication after lumbar puncture. Anesthesiologists are the most likely to be consulted for the treatment. PDPH may be debilitating for a patient and can interfere with daily activities and quality of life. Methods: Fifty patients of both sexes, aged 18–50 years and ASA I and II undergoing elective lower abdominal and pelvic surgery under spinal anesthesia were included in this randomized double-blind study. Patients were randomly divided into 2 groups 25 each: hydrocortisone group received intravenous hydrocortisone 100 mg every 8 h for 48 h and mannitol group received intravenous infusion of mannitol 20% 100 ml over 30 min followed by 100 ml every 12hours. Mean (±SD) of headache intensity at 0, 6, 12, 24 and 48 h after beginning of treatment was assessed using visual analogue scale. Results: There was no significant difference regarding headache intensity between two groups before beginning of treatment. The VAS was significantly reduced in hydrocortisone group than in mannitol group at 6, 12, 24 h with P-value 0.030, 0.007, 0.004 respectively. At 48 h, both groups had nearly the same VAS of headache intensity, with P-value 0.305. Conclusion: Both intravenous hydrocortisone and mannitol intravenous infusion were efficient in reducing postdural puncture headache within 48 h. Hydrocortisone showed earlier and significant relief of headache.
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spelling doaj.art-5de12138307b4d7abacb2aef83fecff82022-12-21T19:37:35ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492016-07-0132335736310.1016/j.egja.2016.05.004Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind studyDina Y. Kassim0Ibrahim M. Esmat1Anesthesia and Intensive Care Medicine, Beni Sweif University Hospitals, El Rehab City, Group 71, Building 15, New Cairo 11841, EgyptAnesthesia and Intensive Care Medicine, Ain Shams University Hospitals, 29-Ahmed Fuad St., Saint Fatima Square, Heliopolis, Cairo 11361, EgyptBackground: Postdural puncture headache (PDPH) is a common complication after lumbar puncture. Anesthesiologists are the most likely to be consulted for the treatment. PDPH may be debilitating for a patient and can interfere with daily activities and quality of life. Methods: Fifty patients of both sexes, aged 18–50 years and ASA I and II undergoing elective lower abdominal and pelvic surgery under spinal anesthesia were included in this randomized double-blind study. Patients were randomly divided into 2 groups 25 each: hydrocortisone group received intravenous hydrocortisone 100 mg every 8 h for 48 h and mannitol group received intravenous infusion of mannitol 20% 100 ml over 30 min followed by 100 ml every 12hours. Mean (±SD) of headache intensity at 0, 6, 12, 24 and 48 h after beginning of treatment was assessed using visual analogue scale. Results: There was no significant difference regarding headache intensity between two groups before beginning of treatment. The VAS was significantly reduced in hydrocortisone group than in mannitol group at 6, 12, 24 h with P-value 0.030, 0.007, 0.004 respectively. At 48 h, both groups had nearly the same VAS of headache intensity, with P-value 0.305. Conclusion: Both intravenous hydrocortisone and mannitol intravenous infusion were efficient in reducing postdural puncture headache within 48 h. Hydrocortisone showed earlier and significant relief of headache.http://www.sciencedirect.com/science/article/pii/S1110184916300332Postdural puncture headacheHydrocortisoneMannitol 20%VAS
spellingShingle Dina Y. Kassim
Ibrahim M. Esmat
Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
Egyptian Journal of Anaesthesia
Postdural puncture headache
Hydrocortisone
Mannitol 20%
VAS
title Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
title_full Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
title_fullStr Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
title_full_unstemmed Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
title_short Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study
title_sort comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache a randomized double blind study
topic Postdural puncture headache
Hydrocortisone
Mannitol 20%
VAS
url http://www.sciencedirect.com/science/article/pii/S1110184916300332
work_keys_str_mv AT dinaykassim comparativestudybetweenhydrocortisoneandmannitolintreatmentofpostduralpunctureheadachearandomizeddoubleblindstudy
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